Sunday, January 19, 2014

Easy crazy


Imagine – in a world somewhat stranger than our own – that you receive an official document from the National Science Authority.  Beneath a colossal stories-high cataract of scientific, social-scientific and statistical data you read this statement: “All evidential information, factual and extrapolative, free of significant confound or contradiction, compiled and crunched longitudinally, leads this body to determine that your wife is not very good-looking.  She is, in fact, at the 71st percentile on the International Scale of Comeliness.”  If you are like many men – but not all – you will find this statement untrue, unacceptable, nonsense.  You will know what you know, that your wife is attractive in all ways that count, more so than many or most others and less so than none but for a few geometrically perfect freaks.

And you will be crazy.

Imagine that your political ideology – for example, anarcho-libertarianism – has been proved by countless projective models to be impracticable and destructive to society.  All taxation is theft.  Law enforcement and courts privately funded, streets privately owned.  Free-market opium dens, brothels and munitions makers on every corner.  Broadly intelligent and experienced, you will know that – as Einstein said – “the theory is correct”: Ultimate freedom is the ultimate good, and therefore the practice of it must be right.  You will have no reason – or (my theory goes) ability – to consider any dissenting viewpoint other than as a target of derision.

And again, you will be crazy.

A delusion is nothing other than a fixed belief that is “resistant to reason or confrontation with actual fact” (dictionary.com).  It is a belief that is “firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary.”  (Psychiatric glossary at http://www.abess.com/glossary.html.)  Delusions are an integral part of the symptomatology of schizophrenia; are the defining feature of delusional disorder, another psychotic diagnosis; are featured in personality disorders such as paranoid personality and narcissism (the narcissist, contrary to his conviction, is not perfect or uniquely desirable).  And yet, as the above examples show, it is quite easy to have a delusional belief.  An anorexic believes her hanging skin, loosened by starvation, is actually fat.  A Jew believes the Messiah hasn’t come yet.  A Christian believes He has.  A humanitarian liberal believes the rich should be forced, at the point of a legislative (and real) gun, to pay the poor.  A conservative knows that the right to property is the right to life.  A “cold warrior” believes we must be aggressive; a pacifist, that we should refuse to engage.   A “depressive personality” cannot consider that the future will not be as bleak as the present; a PhD psychologist is sure he is smarter than a Master’s-level counselor.

Do you think you are smarter than you actually are?  Insane!  Do I think I’m a superb therapist?  I may be nuts.  I remember a nice young couple who came for marital help.  The wife complained that her husband could never accept her view of any situation: He qualified or disagreed all the time, feeling convinced only in his difference.  The perversity was so deep that he could not accept the sky was blue when she claimed it.  It was “blue-green.”  He could subclinically qualify for two diagnoses: delusional and “oppositional-defiant.”  This raises the question: Is there something in characterological oppositional-defiance – a diagnosis that many children have (DSM code 313.81) – that is delusional?  If so, what is the commonality?  Is there a connection between a child’s need to “take a stand” against authority or reason, and the adult’s intransigent craziness?  What makes holding to wrong beliefs desirable and necessary, as necessary as our sense of Self?

Today’s casual theory says that delusional craziness comes when thinking identity replaces feeling identity:  We lose touch, through childhood, with the feeling self which is intrinsic value and meaning.  When a young person is accepted, loved for himself and continues to feel, he is open to stimuli and fundamentally values the world.  A poetic formulation would be: Love makes a heart of gold which shines in the world even when the world is dark.  The child doesn’t grow to have to be right – have right ideas because he already is right.  He doesn’t have to be something or cleave to a fantasy because he already is something.  The heart beats from its steady light, and all feelings are simply variations of that underlying identity.

Defenses cover not only pain, but a repressed heart’s emptiness.  One defense that often covers emptiness is knowing, or rather “thinking-knowing”: I don’t feel my parents’ love, but I “know” they love me.  I please no one in my life, but I “know” I am the good girl or the bad boy or the smart one.  Thinking-knowing is an extrinsic identity, like an obsessive-compulsive’s perfectly aligned books or clothes, that gives a hollow feeling-self substance.  Or rather, structure that feels like substance.

There is something about identity emptiness that requires the antidote of perfection: the absolute rightness of a belief or conceit.  Liberals are socialists; conservatives hate people. Without it, the person will instantly sense disintegration: the dissolving of the thinking-knowing self into pain and mute emptiness.  Thought and feeling have become binary: one and zero, existing or not-existing.  If I do not know, I am forced to feel.  As a youngster I had no narcissism yet, but could not tolerate even minutely misaligned corners of a folded sheet of paper.  Many children must color every centimeter of a page, leaving no empty place, or must color rigidly between the lines: A stray crayon stroke is chaos, wrongness.  Later, as a teenager, I needed to believe Ayn Rand’s philosophy.  It created perfectionism, with the added benefit of guaranteed happiness (a sense of superiority).  Any thinking-knowing state that the extrinsic identity comes to invest in must not have a chink in it, or spring a leak.  Otherwise, painful emptiness would be released.

The link, as I see it, between thought-identity and “oppositional-defiance” such as the husband possessed, is that agreement is passivity of the thinking-knowing mind which means to be “done to” and therefore to have to feel.  The defense mechanism of thought must be an iconoclast, always a re-inventor.  I had a boss once who could never agree with anything I proposed without adding his own angle -- "That's true, too," he'd always say; an associate who unconsciously knee-jerk denied most everything I said; a client who paraphrased every question I asked him before responding: Rephrasing was his “catcher’s mitt” of thought that intercepted each stimulus before it could hit him in the chest – the no-man’s land of his heart.

Janov, in The Primal Scream, wrote about a shut down child’s becoming, “one day,” more unreal than real: The Rubicon of repression of self has been crossed and a neurotic is born.  This is basically what I’m talking about here: where we become thought- or knowledge-based in the absence of the feeling self.

I believe there’s essentially no difference between the casual delusion of someone who believes his child is handsome, and a forty-year-old man’s certainty that the CIA has snuck into his apartment and moved his hot water heater – again – three inches to the left.*  Pain and emptiness, the earlier and more balefully they infest the forming self, can be beyond formidable, as Modrow chillingly describes in How To Become a Schizophrenic.  As this reality grows, the person must become something other than real to save himself.


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* From my crisis triage days.


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Comments are welcome, but I'd suggest you first read "Feeling-centered therapy" and "Ocean and boat" for a basic introduction to my kind of theory and therapy.